Vaccine showdown

By EdSource Staff

Updated on April 14, 2017

The EdSource Today editorial team has selected several significant education issues to present in timelines that will be regularly updated. The timelines allow you to quickly get up to speed on EdSource’s coverage of these notable issues. Scroll down the page to get a snapshot of the key events that occurred. Click on the headlines to read the articles that explain why, when, and how the events evolved, as well as the most recent developments.

The first sign of a problem appeared on Dec. 28, 2014, when an 11-year-old unvaccinated child in California was hospitalized with a suspected case of measles. The child’s only unusual activity had been a visit to one of two adjacent theme parks in Southern California — Disneyland and Disney California Adventure — popular destinations for travelers from countries where vaccination rates are low and measles, a highly contagious and sometimes fatal virus, is endemic.

The largest measles outbreak in California in almost 20 years was about to begin, bringing with it an emotional debate about public health, parental rights and school vaccination requirements.

On June 30, 2015, Gov. Jerry Brown signed legislation creating one of the strictest vaccination laws in the country. The law goes into effect Jan. 1, 2016. Based on EdSource articles and commentaries, the following storyline tracks the debates and legislative actions that have occurred since 2012.

2012

February 23, 2012

Concern about vaccination rates prompts first round of change

Then-Assemblyman Richard Pan, a pediatrician, introduces Assembly Bill 2109 to make it more difficult for parents to obtain a personal belief exemption.

Health officials in California have expressed concern about the falling vaccination rates for kindergartners in some pockets of the state. Between 2008 and 2010, the number of kindergartners who opted out of vaccinations because of a "personal belief exemption" increased by 25 percent.

Two exemptions exist: a medical exemption and a personal belief exemption. Pan's bill would require parents to meet with a health provider, learn about the benefits of vaccinations and obtain the provider's signature before obtaining a personal belief exemption.

Update

April 13, 2012

The Assembly Health Committee issues its analysis of Assembly Bill 2109 and includes the federal Centers for Disease Control and Prevention's history of the impact of vaccinations on preventing communicable diseases, including polio, smallpox, German measles (rubella), mumps and measles.

Vaccinations are widely considered one of the greatest public health achievements of the 20th century.

Here's how diseases flourished before vaccinations, according to data from the CDC. In 1900, 21,064 smallpox cases were reported, and 894 patients died. In 1920, 147,991 diphtheria cases were reported, and 13,170 patients died. In 1922, 107,473 pertussis cases were reported, and 5,099 patients died.

Measles were eliminated in the U.S. in 2000 after a prolonged public health campaign to give children the vaccine, which first became available in the U.S. in 1963.

In the 1950s and early 1960s, 3 million to 4 million children and adults in the U.S. contracted the disease each year, 400 to 500 died, 48,000 were hospitalized and 4,000 developed encephalitis, which is a swelling of the brain, according to the CDC.

Update

September 30, 2012

Parents who wish to refuse vaccinations for their children must have a health practitioner sign the personal belief exemption form. Previously, parents could stop by the school secretary’s desk and sign the back of their child’s blue immunization card themselves to opt out of vaccinations.

In his signing message, Brown adds the option for parents to opt out of vaccination requirements for their children based on "religious beliefs."

The law will go into effect on Jan. 1, 2014.

2013

Update

July 1, 2013

They include children who have never been vaccinated, those who have received some vaccinations and some, according to school nurses, who actually are vaccinated but have a personal belief exemption form because it was simpler for their parents to sign than to track down vaccination documentation.

Overall, the number of students with personal belief exemptions is small -- just 3.2 percent of the total number of California kindergartners.

But in some schools, so many students hold personal belief exemptions that unvaccinated students have lost the protective immunity known as "herd immunity." When at least 90 percent of the population is vaccinated against measles, the difficulty of spreading the disease is so great that unvaccinated people are likely to be protected.

Article

April 6, 2014

School nurses say they devote their careers to children's public health. In schools where high percentages of children are not fully vaccinated, nurses face parents who don't believe in public health or the science behind it.

One tough case: At the Yuba River Charter School in Nevada City, 81 percent of kindergartners in 2013-14 received personal belief exemptions to state-mandated vaccinations.

Multimedia

April 7, 2014

Use the EdSource 2013-14 Kindergarten Immunization Database to investigate how many kindergarten students were vaccinated at any public, charter or private California elementary school in the 2013-14 school year.

The data show that rural students are more likely to attend schools where a large number of students have personal belief exemptions.

In general, public charter schools and private schools have greater numbers of students with exemptions than non-charter public schools.

Update

April 18, 2014

The California Department of Public Health has received reports of 58 confirmed measles cases from Jan. 1 through April 18, the highest number reported for that period since 1995, according to the Centers for Disease Control and Prevention.

December 28, 2014

The first reported case of the Disneyland measles outbreak

An 11-year-old unvaccinated child is hospitalized in California with a suspected case of measles. The child had visited Disneyland or Disney California Adventure in Anaheim. The parks are a destination for international travelers.

Update

January 5, 2015

The California Department of Public Health is notified of five suspected measles cases in California and two in Utah.

All of those who are infected report visiting one or both Disney parks in Anaheim from Dec.17 through Dec. 20.

Exactly how people were exposed to measles in the Disney parks is not known, according to the California Department of Public Health. The outbreak started when at least 40 people contracted the measles virus after visiting or working at Disneyland or Disney California Adventure in Orange County.

Multimedia

February 10, 2015

Got a child who is in, or will be entering, kindergarten? Use this database to see the 2014-15 vaccination rates at your child’s school. Religious belief exemptions are included as personal belief exemptions.

Article

April 28, 2015

A three-hour hearing at the Senate Judiciary Committee brings forth hundreds of parents who traveled to Sacramento to testify against the measure, some with young children in tow. Some parents said they had the right to decide whether to vaccinate their child.

“The courts, over and over again, have stated that this is an appropriate place for the state to be involved,” Sen. Allen said.

The Senate Judiciary Committee approves SB 277 and the bill moves to the Senate floor.

Article

June 30, 2015

School districts consider how Senate Bill 277 could affect their enrollment, their funding and their communities.

Nevada County has the highest vaccine refusal rate in the state – 20 percent of kindergartners hold personal belief exemptions.The county’s student enrollment is 12,000, and if 20 percent decided to leave the school system rather than submit to vaccinations, that would make a dent in already declining enrollment, district officials said.

And a change in the law would upend a way of life in a community of alternative medicine practitioners and ardent opponents to vaccination requirements.

“If it really does happen, it’s going to be wild up here,” said Sharyn Turner, coordinator of school health services at the Nevada County Office of Education.

June 30, 2015

SB 277 signed into law

“While it’s true that no medical intervention is without risk, the evidence shows that immunization powerfully benefits and protects the community.”

- Gov. Jerry Brown

After months of heated testimony and amendments to the bill, SB 277, which will end personal belief exemptions, is signed by Gov. Jerry Brown. Religious belief exemptions to vaccinations were never part of state statute and also are eliminated.

Article

September 23, 2015

Attorneys with the Orange County Department of Education state that the new vaccine requirements under Senate Bill 277 apply equally to special education students, a group some parents believed would be exempt due to federal protections.

Article

October 6, 2015

“We didn’t have to fall short and we did,” said Lauren Stephens, who with former Assemblyman Tim Donnelly, R-Twin Peaks, coordinated the referendum campaign.

Vaccination opponents say they will fight the legality of Senate Bill 277 in court.

But a day earlier, the U.S. Supreme Court dimmed the likelihood of success of a federal Constitutional challenge to required school vaccinations. The court let stand a lower court ruling that affirmed the constitutionality of a New York regulation authorizing school officials to temporarily exclude unvaccinated students during an outbreak of a vaccine-preventable disease.

January 1, 2016

New vaccination law goes into effect

The law, Senate Bill 277, ends the personal belief exemption to state-required vaccinations for children in public or private day care and K-12 education.

Still unknown is whether students who receive special education services, and are thereby federally entitled to those services, are required to be fully vaccinated. The California Department of Public Health says parents should consult their local school districts about implementation.

California joins West Virginia and Mississippi as the third state that does not allow non-medical exemptions to vaccinations for school entry.

Article

January 6, 2016

California now has one of the strictest vaccination laws in the country, but ambiguity in its wording has left school districts deciding on their own whether to grant special education students a de facto exemption.

The California Department of Public Health and the California Department of Education have not yet issued guidance on how to apply the vaccination law to special education students. Under the federal Individuals with Disabilities Education Act, students who qualify for special education services, such as speech therapy or small group instruction, must receive those services. Failure to comply leaves districts vulnerable to lawsuits from parents.

Article

January 19, 2016

Vaccination rates increased across the state for kindergartners in 2015-16 as schools reacted to the news that their daily attendance figures would be scrutinized if they had high numbers of students who were only partially vaccinated, according to a summary analysis by the California Department of Public Health, which released its school-by-school immunization data.

The kindergarten vaccination rate rose to 92.9 percent, an increase of 2.5 percent from the previous year, and a rise that the state agency attributed to a 2.5 percent drop in “conditionally admitted” kindergartners who have completed some but not all of their vaccinations.

Article

April 12, 2017

Vaccination rates hit an all-time high for California kindergartners, the California Department of Public Health said Wednesday as it announced its first findings since a new law ended the era of the “personal belief exemption” that allowed thousands of parents to choose not to vaccinate their children who attend public and private schools.
The percentage of kindergartners who received all required vaccines rose to 95.6 percent in 2016-17, up from the 92.8 percent rate in 2015-16. This is the highest reported rate for the current set of immunization requirements, which began in the 2001-02 school year, the state said.